A treatment algorithm for Charcot foot arthropathy

Abstract

Charcot arthropathy of the midfoot imparts a severe negative impact on health related to quality of life. Treatment has been historically accommodative. Surgery was reserved for those who could not be accommodated with an orthosis, or developed ulcers or deep bonyinfection. The remaining ulcer and infection free as well as the possibility of maintaining the walking capacity with commercially available therapeutic footwear have been previously defined as favorable outcome. Using this definition of a favorable outcome, favorable results can be achieved in 60% of patients without surgery. When surgery is advised, a treatment algorithm is presented.